RAAS阻滞剂对高血压患者房颤预防的研究进展

Research Progress of RAAS Blockers in the Prevention of Atrial Fibrillation in Hypertensive Patients

摘要: 高血压病是常见的心血管疾病，心房颤动是临床常见的心律失常，高血压和房颤发生率的持续上升给患者和社会卫生保健系统造成重大经济负担，已成为了全世界范围内的现代热点医学问题。抗心律失常药物治疗房颤仍然是主流，但其易发生恶性心律失常并有复发风险。对房颤的“上游”研究引起国内外学者的重视，及早干预房颤的危险因素对制定一级房颤预防策略、改善临床预后具有重要意义。由于RAAS阻滞剂有效的降压和影响心房肌细胞的离子电流和持续性，预防心房纤维化，减少左房大小，缓解左心室肥厚，调节交感神经活动等潜在作用可提供潜在抗心律失常好处，愈来愈多的研究支持调节RAAS在降压治疗的同时降低房颤的发生，针对房颤发生重要机制为靶点的预防性药物值得人们关注及探讨。因此，本文将从高血压、RAAS与房颤的关联研究作一综述。

Abstract: Hypertension is a common cardiovascular disease, and atrial fibrillation is a common clinical ar-rhythmia. The continuous increase of the incidence of hypertension and atrial fibrillation has caused a great economic burden to patients and social health care system, and has become a mod-ern hot medical problem all over the world. Antiarrhythmic drugs are still the mainstream in the treatment of atrial fibrillation, but they are prone to malignant arrhythmias and have the risk of recurrence. The “upstream” research on atrial fibrillation has attracted the attention of scholars at home and abroad. Early intervention in the risk factors of atrial fibrillation is of great significance in formulating the prevention strategy of primary atrial fibrillation and improving the clinical progno-sis. As RAAS blockers can effectively reduce blood pressure, affect ionic current and persistence of atrial myocytes, prevent atrial fibrosis, reduce left atrial size, alleviate left ventricular hypertrophy, regulate sympathetic nerve activity and other potential effects, which can provide potential anti-arrhythmic benefits, more and more studies support regulating RAAS to reduce the occurrence of atrial fibrillation while reducing blood pressure. Preventive drugs targeting the important mecha-nism of atrial fibrillation deserve people’s attention and discussion. Therefore, this article will re-view the research on the relationship between hypertension, RAAS and atrial fibrillation.